Individual provider Active NPI

Bogdan Leszek Nowakowski, MD

  • Pulmonary Disease Physician
  • Gonzales, LA
National Provider Identifier
1659476265
Registry record updated Jun 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
12969R Issued in LA
Practice address
1429 E. Highway 30
Gonzales, LA 70737
Phone
(225) 647-6900
Fax
(844) 766-1659
NPI assigned
Sep 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 12969R LA
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 12969R LA
Pulmonary Disease Physician 207RP1001X 12969R LA Primary

Addresses

Primary practice location

1429 E. Highway 30
Gonzales, LA 70737

Mailing address

P.O. Box 400
Brittany, LA 70718-0400
Phone (225) 647-6900

Other identifiers 6

IdentifierTypeStateIssuer
1555100MedicaidLA
7014046OtherLAAETNA POS/PPO
G1360OtherLABLU CROSS 5 DIGIT
48-00155OtherUCH
72-1498557001OtherLACIGNA
2215329OtherLAAETNA HMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110614000770 LA Practitioner - Pulmonary DiseasePractitioner - Internal Medicine 7719064690 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Internal Medicine
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pulmonary and Digestive Clinic, Inc.Group PAC ID 7517916612, 2 clinicians

Practice addresses (Care Compare)

1429 E Hwy 30
Gonzales, LA 70737-4765
Phone (225) 229-9377

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
12969RLAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sleep Rite PSG LLC CurrentSince Dec 1, 2013 Accepting new patients
Pulmonary & Digestive Clinic Inc Pulmonary Disease CurrentSince May 1, 2001 Accepting new patients
Sleep Clinic LLC PastSince May 1, 2001 Accepting new patients
Sleep Rite DME, LLC Past Accepting new patients

Locations

8251 Summa Ave
Ste C
Baton Rouge, LA 70809
Phone (225) 766-5656

1429 E Highway 30
Gonzales, LA 70737
Phone (225) 229-9377

14076 Highway 44
Gonzales, LA 70737
Phone (225) 647-6900

3216 N Turnbull Dr
#B
Metairie, LA 70002
Phone (504) 373-6717

8814 Veterans Memorial Blvd
#3304
Metairie, LA 70003
Phone (225) 766-5656

Interoperability endpoints

  • Direct secure messaging: bogdan.nowakowski.1@12094.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/12094/brand/1/csg/1/fhir/r4

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654732800000",
    "number": "1659476265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 400",
            "city": "BRITTANY",
            "state": "LA",
            "postal_code": "707180400",
            "telephone_number": "225-647-6900",
            "fax_number": "844-766-1659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1429 E. HIGHWAY 30",
            "city": "GONZALES",
            "state": "LA",
            "postal_code": "70737",
            "telephone_number": "225-647-6900",
            "fax_number": "844-766-1659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOWAKOWSKI",
        "first_name": "BOGDAN",
        "middle_name": "LESZEK",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "12969R",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "LA",
            "license": "12969R",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "LA",
            "license": "12969R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1555100",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA POS/PPO",
            "identifier": "7014046",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLU CROSS 5 DIGIT",
            "identifier": "G1360",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCH",
            "identifier": "48-00155",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "72-1498557001",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "2215329",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gonzales, LA

Sources for this page

Verify at the official NPI Registry.